AIDS InfoNet Logo
This website is certified by Health On the Net Foundation. Click to verify.
This site complies with the HONcode standard for trustworthy health information:
verify here.

The Henry J. Kaiser Family Foundation
Site of the Week
November 2003

The Health Leader Award 2006
The Health Leader Award 2006

The HOPE Reward

Med411.com Medical Award

HealthAtoZ.com Featured Site Award

BuscaSalud.com

IBS Tales Hope Award

HealingWell.com Editor's Choice Award

Listed in Listed in Treasures of the Internet


AIDS InfoNet Logo.  The AIDS InfoNet - Reliable, Up-to-Date AIDS Treatment Information
International Association of Providers of AIDS Care
Revised May 30, 2013

Fact Sheet 680

Interferon and Ribavirin


ASTANDARD TREATMENT FOR HEPATITIS C
INTERFERON (IFN)
   WHAT IS INTERFERON (IFN)?
   HOW IS INTERFERON USED?
   WHAT ARE THE SIDE EFFECTS?
RIBAVIRIN
   WHAT IS RIBAVIRIN (RBV)?
   HOW IS RIBAVIRIN USED?
   WHAT ARE THE SIDE EFFECTS?
COMBINATION IFN/RBV THERAPY
   WHO SHOULD USE IFN/RBV?
   HOW DO IFN AND RBV REACT WITH HIV MEDICATIONS
THE BOTTOM LINE



STANDARD TREATMENT FOR HEPATITIS C

The standard treatment for hepatitis C (HCV) is the combination of interferon (IFN) and ribavirin (RBV) taken for 48 weeks. Unfortunately, this combination has serious side effects and is not very effective. These drugs are discussed below.

 


 

INTERFERON (IFN)


WHAT IS INTERFERON (IFN)?

IFN is a protein made by various cells of the immune system, including white blood cells. IFN is produced as a response to “foreign” cells including viruses, bacteria, parasites, and tumor cells. The name “interferon” comes from IFN’s ability to interfere with the multiplication of these foreign cells.

During an infection, IFN is released and increases the body’s immune response. This accounts for many of IFN’s side effects (see below.) There are different classes of IFN, including: alpha, beta gamma and lambda. Synthetic interferons have been developed using DNA technology. There are currently 12 pharmaceutical versions of interferon with more being studied..

Various types of interferon have been approved to treat different diseases. Recent research has focused on using interferon to enhance the effects of other therapies, for example to treat breast cancer.

 


HOW IS IFN USED?

Standard IFN is injected under the skin three times a week. The usual dose is 3 million international units (MIU). IFN is provided as a powder that gets dissolved in sterile water, or in pre-filled syringes. The volume of IFN that gets injected is very small, about 0.5 mL or 10 drops. The needle is about ½ inch long. Dosing is normally based on patient weight.

In 2001, the FDA approved a new form of IFN. Pegylated interferon stays in the body longer and can be injected just once a week. Pegylation means attaching strands of polyethylene glycol (PEG) to a molecule. PEG-IFN has become the standard form of IFN to treat HCV. Interferon should be stored in the refrigerator but must be kept from freezing.

 


WHAT ARE THE SIDE EFFECTS?

IFN can cause a shortage of different types of blood cells. A shortage of a type of white blood cells called neutrophils (neutropenia) can reduce the ability to fight infections. A shortage of red blood cells is called anemia (see fact sheet 552.) A drop in platelets (thrombocytopenia) can lead to easy bleeding and bruising.

Flu-like symptoms follow each injection of interferon in about half of all patients. These include fatigue (see fact sheet 551,) fever, chills, headache, and muscle aches and pains. Some patients develop diarrhea (see fact sheet 554.) Many people find that these IFN side effects become less severe after repeated injections. They can be managed with simple pain relievers such as ibuprofen or antihistamines.

Depression, anxiety and thoughts of suicide have been reported. These might be caused by the diseases being treated or the IFN.

Because IFN is injected, former drug injectors may be uncomfortable about using needles and may prefer to have the dose administered by a health care provider.

 


 

RIBAVIRIN (RBV)

WHAT IS RIBAVIRIN (RBV)?

Ribavirin (RBV) is a drug that was discovered in 1970. The way it fights viruses is not well understood.
RBV was approved in 1985 in an inhaled form to fight a form of influenza in children. Used by itself, RBV is not effective against HCV.

 


HOW IS RBV USED?

RBV is taken by mouth as tablets, capsules, or in liquid form. It is normally taken twice a day with food.

The standard dose depends on the genotype of hepatitis C. It is normally between 800 mg and 1,400 mg per day. Tablets are 200 mg each. Current treatment guidelines recommend doses of RBV based on patient weight.

 


WHAT ARE THE SIDE EFFECTS?

The main side effect of RBV is anemia (reduction in the number of red blood cells, see fact sheet 552.) It usually shows up in the first four weeks of treatment and then gets better. Anemia can worsen some heart conditions.

RBV can cause birth defects. Female patients taking RBV must not get pregnant during treatment and for 6 months after ribavirin is stopped. This is also true for female partners of male patients taking RBV.

 


COMBINATION IFN/RBV THERAPY

Studies of the combination of IFN and RBV showed that it worked better to treat HCV than either drug alone. The combination was approved by the FDA in 1998. It has become the standard treatment of HCV. The length of treatment can be from 12 to 48 weeks, depending on the HCV genotype (see fact sheet 674) and how well the treatment is working.

 


WHO SHOULD TAKE IFN/RBV?

The combination of IFN and RBV is the only therapy currently approved by the FDA to treat HCV. People who test positive for HCV might spontaneously (without medications) clear HCV. If they don’t, they should begin treatment with IFN/RBV within 12 weeks of infection.

HCV is more serious in people who also are infected with HIV. This is called “coinfection.” See fact sheet 507 for more information on HCV/HIV coinfection.

 


HOW DO IFN AND RBV REACT WITH HIV MEDICATIONS?

RBV intensifies the effect of ddI, a drug used to fight HIV (see fact sheet 413) and can cause dangerous side effects. They should not be used together. The anti-HIV drug zidovudine (see fact sheet 411) can cause anemia and should not be combined with RBV.

 


THE BOTTOM LINE

The combination of IFN and RBV is the standard treatment for HCV. The treatment can be difficult to take. About 15% of patients with HCV stop treatment due to side effects. A higher proportion of people who have both HIV and HCV experience serious side effects.. Many other drugs are being studied to treat HCV.

 


 


Back to Fact Sheet Categories



New Mexico AIDS Education and Training Center The University of New Mexico Health Sciences Center International Association of Providers of AIDS Care

 

The AIDS InfoNet is a project of the New Mexico AIDS Education and Training Center at the University of New Mexico Health Sciences Center,
and the International Association of Providers of AIDS Care.
webmaster@aidsinfonet.org

 

United States National Library of Medicine

Partially funded by the National Library of Medicine



Search Our Site
Newest Fact Sheets
Print This Fact Sheet
You can print this fact sheet on a single page in Microsoft Word (.doc) format or Adobe Acrobat (.pdf) format. Click on the links below to open the document in your browser and then print it.
 Adobe Acrobat PDF
 Microsoft Word

You can print directly from your browser using the link below. The printout will probably go onto a second page.
 Print Version (Web)

Monthly E-mail Updates

The InfoNet updates its Fact Sheets frequently. A listing of each month's changes is posted to several e-mail lists.

If you would like to receive this monthly update by personal e-mail, please provide your e-mail address below, and click on the "Submit" button.



Subscribe
Unsubscribe